Endocrine Abstracts

Introduction: Pregnancy results in a significant change in pituitary gland size and function.Due to this physiological adaptation, management of pituitary adenomas during pregnancy represents a particularly complex challenge. Aim of this study was to focus on a single referral institution experience with special attention to this subgroup of patients: pregnant woman affected by pituitary adenoma.Materials and methods: This is a des...

Introduction: Pasireotide long acting release (LAR) is approved for second line treatment of acromegaly. We present 3 patients with aggressive acromegaly treated with a personalized de-escalation approach.Case 1: A 61-year-old female affected by acromegaly reisistant on first-line SSAs. In 2015 therapy was switched to pasireotide LAR 60 mg every 28 days. After two years, the IGF-I level touched the lower age range and therapy was downscaled to pasireotid...

Background: Cushing’s disease, the most common cause of endogenous Cushing’s syndrome, is caused by a pituitary tumor secreting adrenocorticotropic hormone (ACTH). Careful selection of treatment and management of the disease and associated comorbidities are necessary to improve prognosis.Case Presentation: A 32-year-old patient came to our observation for appearance of weight gain with abdominal obesity, hirsutism and amenorrhea. On suspicion o...

Introduction: Non functioning pituitary adenomas (NFPAs) are the most common type of pituitary tumors and are often invasive, resulting in high relapse rates. The post-surgical treatment for NFPAs remains a debated issue and include radiation therapy and additional surgery. Several clinical studies have demonstrated that dopaminergic and somatostatin receptors (SSTRs) are widely expressed in NFPAs. Furthermore, recent studies have shown the potential effectiveness of somatosta...

The use of FreeStyle Libre (FSL) or Flash Glucose Monitoring (FGM) system becomes increasingly popular among people with diabetes, especially type 1 diabetes (T1DM) and several randomized and controlled study have shown how its use is associated with less and shorter hypoglycemic events without deterioration of HbA1c. Nevertheless, there are not yet consistent and lasting data reporting the impact of FGM in people with diabetes in real-life conditions. In this study we evaluat...

PRRT is a treatment choice for inoperable or metastasized neuroendocrine tumours and this therapy seems more effective in the biochemical and volume control of disease than SSA. We investigated the role of medical therapy with SSA and PRRT in patients with well and moderately differentiated neuroendocrine tumours. We evaluated 55 patients with well or moderately differentiated neuroendocrine tumours; 31 patients with either metastatic, unresectable or functioning tumours were ...

GH excess is considered as one of the causes of secondary osteoporosis with an increased risk of vertebral fractures in men and post-menopausal women with acromegaly. GH excess in acromegaly is also frequently associated with type 2 diabetes which is considered as a risk factor for fragility fractures in the general population. In this cross-sectional study, we evaluated whether type 2 diabetes may influence the prevalence vertebral fractures in acromegaly. Fifty-seven males w...

Hyperprolactinemia may cause bone loss in pre-menopausal women and men. Data on fractures are scanty and it is still unclear which is the skeletal impact of hyperprolactinemia in post-menopausal women. The aim of this study was to evaluate the prevalence of vertebral fractures in post-menopausal women with hyperprolactinemia.Forty post-menopausal women (median age 57 years, range: 47–81) with prolactin (PRL)-secreting adenoma and 119 control post-me...

Patients with acromegaly resistant to conventional drug treatment currently can advantage with GH-receptor antagonist pegvisomant. To date, at doses up to 40 mg/day, it is capable of normalizing circulating IGF1 in until 97% of patients. Here we present the multicenter experience in Rome with Pegvisomant as a therapeutic option in acromegaly. This is an observational study including a total of 61 patients (21 males and 40 females) treated with pegvisomant for up to 7 years. Of...

Loss of function of succinate dehydrogenase (SDH), caused by mutations in each of the 4 subunits – SDHA/B/C and D – is associated with development of phaeochromocytomas and paragangliomas (PPGLs). The mutations lead to loss of enzymatic activity and subsequent accumulation of the oncometabolite succinate, a driver of tumourigenesis. It is well established but poorly understood why mutations in SDHB are associated with more aggressi...